2020 First Dollar Coverage Going Away Not Set in Stone?

[yaknow1]

I don't think it hurts to talk about it, but there there is no solution in place.

All we know is that if the law stands like it is now in 2020, C and F will no longer be available to new beneficiaries starting 1/1/2020.

The question becomes, how will the market adjust? Will D and G replace C and F in the GI landscape? Will we have new letter plans to offer in 2020 that take the place of C and F?

This is my big gripe. Large employers keep ending their retiree plans pushing them into GI plan F. Those people are going to be stuck like Chuck in a closed block in 4 years.

I already recommend leaving Plan F for Plan D, G, or N so I won't have any qualms bringing up what is already law and what both Republicans and Democrats wanted.

New Era is rolling out a plan D. Wonder what caused that to come about?

 

[wln417]

what's sw... sw... Sw...?

 

[Justin Bilyj]

Some Will Some Won't So What

 

[Medicareguy]

Legislation is passed.
Congress Schedules End to Insurance Coverage of Medicare Part B Deductible | ElderLawAnswers

 

[goillini52]

Is that your Ricky Ricardo impression?

Pretty doggone good.

Hahaha, Vic's got some 'splainin to do.

 

[wln417]

TITLE IV--OFFSETS

Subtitle A--Medicare Beneficiary Reforms

SEC. 401. LIMITATION ON CERTAIN MEDIGAP POLICIES FOR NEWLY
ELIGIBLE MEDICARE BENEFICIARIES.

Section 1882 of the Social Security Act (42 U.S.C. 1395ss) is
amended by adding at the end the following new subsection:
``(z) Limitation on Certain Medigap Policies for Newly Eligible
Medicare Beneficiaries.--
``(1) <<NOTE: Effective date.>> In general.--
Notwithstanding any other provision of this section, on or after
January 1, 2020, a medicare supplemental policy that provides
coverage of the part B deductible, including any such policy (or
rider to such a policy) issued under a waiver granted under
subsection (p)(6), may not be sold or issued to a newly eligible
Medicare beneficiary.
``(2) Newly eligible medicare beneficiary defined.--In this
subsection, the term `newly eligible Medicare beneficiary' means
an individual who is neither of the following:
``(A) An individual who has attained age 65 before
January 1, 2020.
``(B) An individual who was entitled to benefits
under part A pursuant to section 226(b) or 226A, or
deemed to be eligible for benefits under section 226(a),
before January 1, 2020.

[[Page 129 STAT. 160]]

``(3) Treatment of waivered states.--In the case of a State
described in subsection (p)(6), nothing in this section shall be
construed as preventing the State from modifying its alternative
simplification program under such subsection so as to eliminate
the coverage of the part B deductible for any medical
supplemental policy sold or issued under such program to a newly
eligible Medicare beneficiary on or after January 1, 2020.
``(4) Treatment of references to certain policies.--In the
case of a newly eligible Medicare beneficiary, except as the
Secretary may otherwise provide, any reference in this section
to a medicare supplemental policy which has a benefit package
classified as `C' or `F' shall be deemed, as of January 1, 2020,
to be a reference to a medicare supplemental policy which has a
benefit package classified as `D' or `G', respectively.
``(5) <<NOTE: Applicability.>> Enforcement.--The penalties
described in clause (ii) of subsection (d)(3)(A) shall apply
with respect to a violation of paragraph (1) in the same manner
as it applies to a violation of clause (i) of such
subsection.''.

Full text at https://www.congress.gov/bill/114th-congress/house-bill/2/text?overview=closed

 

[goillini52]

TITLE IV--OFFSETS

Subtitle A--Medicare Beneficiary Reforms

SEC. 401. LIMITATION ON CERTAIN MEDIGAP POLICIES FOR NEWLY
ELIGIBLE MEDICARE BENEFICIARIES.

Section 1882 of the Social Security Act (42 U.S.C. 1395ss) is
amended by adding at the end the following new subsection:
``(z) Limitation on Certain Medigap Policies for Newly Eligible
Medicare Beneficiaries.--
``(1) <<NOTE: Effective date.>> In general.--
Notwithstanding any other provision of this section, on or after
January 1, 2020, a medicare supplemental policy that provides
coverage of the part B deductible, including any such policy (or
rider to such a policy) issued under a waiver granted under
subsection (p)(6), may not be sold or issued to a newly eligible
Medicare beneficiary.
``(2) Newly eligible medicare beneficiary defined.--In this
subsection, the term `newly eligible Medicare beneficiary' means
an individual who is neither of the following:
``(A) An individual who has attained age 65 before
January 1, 2020.
``(B) An individual who was entitled to benefits
under part A pursuant to section 226(b) or 226A, or
deemed to be eligible for benefits under section 226(a),
before January 1, 2020.

[[Page 129 STAT. 160]]

``(3) Treatment of waivered states.--In the case of a State
described in subsection (p)(6), nothing in this section shall be
construed as preventing the State from modifying its alternative
simplification program under such subsection so as to eliminate
the coverage of the part B deductible for any medical
supplemental policy sold or issued under such program to a newly
eligible Medicare beneficiary on or after January 1, 2020.
``(4) Treatment of references to certain policies.--In the
case of a newly eligible Medicare beneficiary, except as the
Secretary may otherwise provide, any reference in this section
to a medicare supplemental policy which has a benefit package
classified as `C' or `F' shall be deemed, as of January 1, 2020,
to be a reference to a medicare supplemental policy which has a
benefit package classified as `D' or `G', respectively.
``(5) <<NOTE: Applicability.>> Enforcement.--The penalties
described in clause (ii) of subsection (d)(3)(A) shall apply
with respect to a violation of paragraph (1) in the same manner
as it applies to a violation of clause (i) of such
subsection.''.

Full text at https://www.congress.gov/bill/114th-congress/house-bill/2/text?overview=closed

That looks like one of Bob Barney's posts.

 

[Justin Bilyj]

HR 2 from my take of it, replaces the outdated doctor payment model called SGR that was enacted in 97. Doctor's are pissed they received a 4.8% payment cut in 02, and congress has been staving off further cuts resultant of the SGR formula. If the cuts go through you would have more doctors dropping out from participating in Medicare.
The new bill replaces the SGR formula with a new merit based system, but until then, doctors get a 5% pay bump leading up to 2020.
The bill isn't paid for fully (25% so far), part of the policies enacted to help pay for this is the raising of part B deductible and part B premium while cutting off plans C and F (no talk of Hi-F).
The ironic thing is many experts agree that causing seniors to pay first dollar coverage for their care would discourage a senior from checking conditions out that may balloon and cause the system more money in the end.

It looks like this law will pass, Boehner and Pelosi and McConnel all allied together to push this through. With the state of Medicare, it would be impossible for me to think that costs for seniors won't go up, it HAS to.

Alternatively, Kaiser did a study about Medigap enrollment trending lower and lower as MA trends higher. They concluded eliminating first dollar coverage plans would exacerbate that Medigap trend lower. It doesn't take an economics professor to know that lower populations equal higher rate increases over time, creating a vicious circle.

Switching gears saw in the paper this morning some editorial about some hack recommending Medicare for everyone, sigh another call for a single payer system. We will all be on MA soon

 

[wln417]

Sorry, didn't mean to put you to sleep, there, Red Grange. The reason it's long is that it is copied directly from the congress website with no editing.

The reason I did that was so everyone could see it and make their own interpretation.

I read it as it has been passed, and it is only going to affect new people ageing in, not any of those we're selling to today.

I could be wrong.

 

[somarco]

only going to affect new people ageing in, not any of those we're selling to today.

New enrollee's for 2020 and later are directly impacted.

Existing policyholders with C & F are impacted in the same way as any frozen block of business. Rates will spiral as they get older and sicker.